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在牙买加西部试行儿科创伤课程:经验教训与未来方向。

Piloting a pediatric trauma course in Western Jamaica: Lessons learned and future directions.

作者信息

Wesson Hadley K, Plant Valerie, Helou Marieka, Wharton Karen, Fray Delroy, Haynes Jeffrey, Bagwell Charles

机构信息

Department of Surgery, Johns Hopkins University, Baltimore, MD, USA.

Division of Pediatric Surgery, Department of Surgery, Virginia Commonwealth University Health System, Richmond, VA, USA.

出版信息

J Pediatr Surg. 2017 Jul;52(7):1173-1176. doi: 10.1016/j.jpedsurg.2017.01.003. Epub 2017 Jan 10.

Abstract

INTRODUCTION

Pediatric injuries are a leading cause of death in low- and middle-income countries (LMICs). Despite this, there are few formal pediatric-specific trauma educational initiatives available in LMICs. While new educational tools are being developed to address this, they have not been piloted in LMICs. In Jamaica, pediatric injuries are a leading cause of hospital admission but care is limited by a lack of training in triage and stabilization. Our objective was to implement and evaluate a pediatric trauma course in Jamaica to determine the impact this may have on further course development.

MATERIALS AND METHODS

A pediatric trauma course was conducted at the Cornwall Regional Hospital in Montego Bay, Jamaica sponsored by the Children's Medical Services International, a nonprofit organization. Participants took part in six didactic modules, an infant airway intubation skills session, and three clinical simulation scenarios. Participants completed a postcourse survey at the conclusion of the course.

RESULTS

Twenty-five participants including surgical, pediatric, and emergency medicine residents from regional- and district-level hospitals in Jamaica participated in the course. Participants viewed the course favorably. Strengths included good review of pediatric trauma physiology, short modules, hands-on practice, and applicable clinical scenarios. Using a Likert-type rating scale of 1 to 10, with 1 being minimal and 10 being very knowledgeable, precourse knowledge was ranked as 5.9, which increased to 9.2 after the course. Using a similar scale, the precourse comfort level to run a pediatric trauma was 4.9 and increased to 8.5 following the course.

DISCUSSION

Implementation of this pilot pediatric trauma course was feasible and successful through collaboration with the hosting regional hospital. The lack of formal pediatric training can be overcome by a course such as this which includes both didactics and hands-on clinical patient simulations.

LEVEL OF EVIDENCE

摘要

引言

在低收入和中等收入国家(LMICs),儿童伤害是主要死因。尽管如此,LMICs中针对儿童的正规创伤教育举措却很少。虽然正在开发新的教育工具来解决这一问题,但尚未在LMICs中进行试点。在牙买加,儿童伤害是住院的主要原因,但由于缺乏分诊和稳定治疗方面的培训,护理受到限制。我们的目标是在牙买加实施并评估一门儿童创伤课程,以确定其对进一步课程开发可能产生的影响。

材料与方法

由非营利组织国际儿童医疗服务机构赞助,在牙买加蒙特哥贝的康沃尔地区医院举办了一门儿童创伤课程。参与者参加了六个理论模块、一次婴儿气道插管技能培训以及三个临床模拟场景。课程结束时,参与者完成了课后调查。

结果

来自牙买加地区和区级医院的25名参与者,包括外科、儿科和急诊医学住院医师参加了该课程。参与者对该课程评价良好。优点包括对儿童创伤生理学的良好复习、简短的模块、实践操作以及适用的临床场景。使用1至10的李克特量表,1表示最少,10表示非常有知识,课前知识评分为5.9,课程结束后提高到9.2。使用类似量表,课前进行儿童创伤治疗的舒适度为4.9,课程结束后提高到8.5。

讨论

通过与主办地区医院合作,实施这一儿童创伤试点课程是可行且成功的。像这样包括理论教学和临床患者实践模拟的课程可以克服正规儿童培训的不足。

证据水平

4级。

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